Tibolone tablets (Livial)

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Take one tablet every day.

During the treatment you will be invited for regular check-ups with your doctor/nurse. It is important that you keep these appointments.

Type of medicineA man-made female hormone
Used forSymptoms of oestrogen deficiency
To prevent osteoporosis
Also calledLivial®
Available asTablets

Tibolone works by mimicking the activity of the female sex hormones, oestrogen and progesterone. It also has some male hormone (androgen) effects. Tibolone helps to restore the balance of female hormones in women who have a lack of oestrogen; it helps to ease symptoms such as hot flushes and night sweats. You will only be prescribed it if these symptoms seriously interfere with your daily life.

Tibolone is also prescribed to help prevent osteoporosis (bone loss). It is only suitable for women who have been through the menopause, and providing there have been at least 12 months since the last natural period. It is prescribed when other, more preferred, treatments are not suitable.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking tibolone it is important that your doctor or pharmacist knows:

  • If you (or a close family member) have had breast cancer.
  • If you have had a cancer that you have been told is hormone-dependent.
  • If you have any unexplained vaginal bleeding.
  • If you have liver disease, or if you have any problems with the way your kidneys work.
  • If you know you have high levels of fat (triglycerides or cholesterol) in your blood.
  • If you have ever had a blood clot in your leg or lungs, or if you have had thrombophlebitis (inflammation of a vein).
  • If you have angina, or if you have had a heart attack or stroke.
  • If there is a possibility you might be pregnant.
  • If you have diabetes mellitus.
  • If you have migraines, or migraine-like headaches.
  • If you have epilepsy.
  • If you have gallstones.
  • If you have a rare inherited blood condition, called porphyria.
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.
  • Before you start taking the tablets, read the manufacturer's printed information leaflet from inside your pack. The manufacturer's leaflet will give you more information about tibolone and a full list of the side-effects which you may experience from taking it.
  • Take one 2.5 mg tablet every day. You may take tibolone at whatever time of day you find easiest to remember, but try to take your doses at the same time of day, each day. You can take the tablets before or after meals. You may find it helps to swallow the tablet with a drink of water.
  • If you forget to take a dose, take it as soon as you remember unless you are more than 12 hours late. If you are more than 12 hours late, leave out the forgotten dose and take your next tablet at the usual time. Do not take two tablets together to make up for a missed dose.
  • Studies have shown that tibolone is associated with a small increased risk of both stroke and endometrial cancer. It may also be associated with an increased risk of breast cancer. Before you take tibolone, your doctor will discuss with you the benefits of the treatment versus its risks. Your doctor will then continue to consider the benefits and risks as you carry on taking the tablets. This is to make sure that the treatment remains suitable for you.
  • Although tibolone is usually suited to short-term use, you will be invited for regular check-ups during treatment. Remember to keep these appointments so that your doctor can check on your progress.
  • It is also important that you go for any regular breast screening and cervical smear tests. Check your breasts regularly for any skin changes, dimpling and lumps. If you notice any changes, speak with your doctor as soon as possible.
  • If you are due to have an operation, tell the person carrying out the treatment that you are taking tibolone. Your treatment may need to be stopped for a while, especially if you are not expected to be fully mobile for a time. This is to reduce the risk of a blood clot.
  • If you are taking tibolone to prevent osteoporosis, there are a number of lifestyle measures that will also help slow down bone loss. Exercise stimulates bone-making cells, which strengthens your bones, so try to take some regular weight-bearing exercise (such as brisk walking, aerobics, dancing, or running). If you smoke, you should try to stop. Also, you should try to cut down on your alcohol intake if you drink more than three units of alcohol daily.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with tibolone. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common tibolone side-effects (these affect less than 1 in 10 women)What can I do if I experience this?
Pain in the lower abdomen, increased weight, unusual hair growth, breast tendernessIf any of these become troublesome, speak with your doctor
Vaginal thrush (redness and itching in the vagina)Speak with your doctor or pharmacist for advice
Vaginal bleeding and spottingThis may happen when you first start tibolone and is nothing to worry about. If it continues for more than a few months, you should let your doctor know about it

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist.

  • Keep all medicines out of the sight and reach of children.
  • Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • Manufacturer's PIL, Livial® 2.5 mg tablets; Merck Sharp & Dohme Limited, The electronic Medicines Compendium. Dated July 2013.
  • British National Formulary; 66th Edition (September 2013) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr Hannah Gronow
Document ID:
1502 (v24)
Last Checked:
Next Review:
The Information Standard - certified member

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